生长激素不同用药频次对高龄患者IVF/ICSI助孕临床结局的影响  

Effect of different frequency of growth hormone on the clinical outcome of IVF/ICSI in elderly patients

作　　者：蒙亚晴 周红[1] 邓曦和[1] 蔡君英 李艳娟 梁贵 Meng Yaqing;Zhou Hong;Deng Xihe;Cai Junying;Li Yanjuan;Liang Gui(Department of Reproductive Center,Maternal and Child Health Care of Guangxi Zhuang Autonomous Region,Nanning Guangxi 530003,P.R.China)

机构地区：[1]广西壮族自治区妇幼保健院生殖医学中心,广西南宁530003

出　　处：《中国计划生育和妇产科》2024年第6期83-87,共5页Chinese Journal of Family Planning & Gynecotokology

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(项目编号:Z20210227)。

摘　　要：目的 探讨重组人生长激素(growth hormone,GH)两种不同的预处理用药频次对高龄患者体外受精/卵胞浆内单精子显微注射(in vitro fertilization/intracytoplasmic sperm injection, IVF/ICSI)助孕中临床结局的影响。方法 回顾性分析广西壮族自治区妇幼保健院生殖医学中心2020年1月至2023年6月IVF/ICSI助孕的35~43岁女性,采用短效GnRH-a长方案并辅助使用GH预处理共242个周期,按照不同GH用药频次分组,A组GH 2 U,一天一次给药,共38个周期,B组GH 2 U,隔天一次给药,共204个周期,采用倾向性得分匹配(PSM),对两组患者年龄、体质量指数(BMI)、抗苗勒管激素(AMH)和基础窦卵泡数(AFC)进行1∶1匹配,匹配容积设为0.02,匹配后两组各38个周期,比较两组患者平均获卵数、可利用胚胎数、优胚数、临床妊娠率等临床指标。结果 匹配后两组的Gn天数、Gn总量差异无统计学意义(P>0.05);hCG注射日E2水平(9 089.56±5 778.61 vs. 5 949.34±3 939.86)、平均获卵数(9.00±6.05 vs. 5.58±3.57)、可利用胚胎数(3.68±2.62 vs. 2.21±1.40)及优胚数(2.58±2.62 vs. 1.50±1.37)比较,差异有统计学意义(P<0.05)。两组患者新鲜周期移植妊娠率、胚胎种植率比较,差异无统计学意义(P>0.05)。移植日期截至2023年12月31日,两组的取卵周期累计妊娠率(44.74%vs. 18.42%)比较,差异有统计学意义(P<0.05)。结论 对于高龄患者IVF/ICSI助孕中采用短效GnRH-a长方案患者,辅助使用GH 2 U qd的用药频次可增加可用胚胎数。Objective To investigate the effect of two different pretreatment frequencies of recombinant human growth hormone(GH)on the clinical outcomes of in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)in elderly patients.Methods Review of 242 cycles of IVF/ICSI assisted reproduction in women aged 35~43 from January 2020 to June 2023 at the Reproductive Medical Center of Maternal and Child Health Care of Guangxi Zhuang Autonomous Region,in which short-acting GnRH-a long protocol with GH pretreatment was used.The patients were divided into two groups based on different GH dosing frequencies:group A received 2 U qd for 38 cycles,and group B received 2 U qod for 204 cycles.Propensity score matching(PSM)was used to match patients in terms of age,body mass index(BMI),anti-Müllerian hormone(AMH),and antral follicle count(AFC)in 1:1 ratio with a matching ratio of 0.02.After matching,each group consisted of 38 cycles,and clinical indicators such as the average number of retrieved oocytes,usable embryos,high-quality embryos,and clinical pregnancy rate were compared between the two groups.Results There were no statistically significant differences in the duration and total dose of gonadotropin(Gn)treatment between the two matched groups(P>0.05).However,there were statistically significant differences in the levels of estradiol(E2)on the day of human chorionic gonadotropin(hCG)injection(9089.56±5778.61 vs.5949.34±3939.86),the average number of retrieved oocytes(9.00±6.05 vs.5.58±3.57)and number of usable embryos(3.68±2.62 vs.2.21±1.40)and number of good-quality embryos(2.58±2.62 vs.1.50±1.37)(P<0.05).There were no statistically significant differences in fresh cycle implantation rate and embryo implantation rate between the two groups(P>0.05).December 31,2023,there was a statistically significant difference in the cumulative pregnancy rate(44.74%vs.18.42%)during the oocyte retrieval cycles between the two groups(P<0.05).Conclusion For elderly patients undergoing short acting GnRH-a long protocol in IVF/ICSI

关 键 词：高龄 生长激素 体外受精 可利用胚胎数 

分 类 号：R714[医药卫生—妇产科学]